Physio Logic’s Contributing Registered Dietitian, Rachel Naar, RD, discusses the causes and treatments of constipation, diarrhea, and irritable bowel syndrome (IBS).

Developing Regular Bowel Movements - Treatments for Constipation, Diarrhea, and IBS | https://physiologicnyc.com/clinical-nutrition/

Developing Regular Bowel Movements

When ya gotta go, you gotta go or sometimes you don’t gotta go at all!

Here we take a deeper dive into some of the most common gastrointestinal conditions, and shed some light on how to provide relief through nutrition and lifestyle changes.

CONSTIPATION

WHAT IS IT?

  • Infrequent and difficult passage of small amounts of hard feces
    ○          Less than 3 bowel movements/week
  • More prevalent among women and all adults over 70 years of age

WHATS GOING ON?

  • Because the function of the large bowel is to reabsorb water and electrolytes, the longer stool is in the colon, the more water is reabsorbed (causing it to be more difficult to pass)
  • May be due to weakened colon muscles

POSSIBLE CAUSES

  • Low fiber intake
  • Low food intake
  • Inadequate fluid intake
  • Low levels of physical activity
  • Irritable bowel syndrome
  • Pregnancy
  • Antibiotics or dietary supplements

HOW DO I FIX IT?

  • Gradual increase in fiber intake
    ○          Fruits & vegetables
    ○          If severe consider fiber supplements/bulk-forming agents (like psyllium husk and oat fiber)
    ○          Foods with mild laxative effects (such as prunes & prune juice)
  • Increase exercise→ regular exercise can help stimulate the process of moving food and stool through the intestines
  • Adequate fluid intake (aim to consume half your body weight in ounces of water everyday)
  • Consider the Squatty Potty for ease of passage https://www.squattypotty.com/
  • Medical treatment
    ○          Talk to your doctor about appropriate stool softeners, laxatives, enemas and suppositories, and biofeedback techniques to relax pelvic muscles

DIARRHEA

WHAT IS IT?

  • Frequent passage of loose, watery stools (usually short-lived & self-limiting)
    ○          Risk of dehydration and electrolyte imbalance if severe or persists

WHAT’S GOING ON?

  • Types of diarrhea:
    ○          Osmotic diarrhea- Results from nutrient malabsorption
    ○          Secretory diarrhea- Intestines secrete excessive fluid into colon (foodborne illness)
    ○          Motility disorders- Accelerated transit of colonic residue

POSSIBLE CAUSES

  • Complication or side effects of multiple GI disorders
  • Infections, medications, and dietary supplements
  • Food intolerance

HOW DO I FIX IT?

  • Correction of underlying medical disorder (e.g. antibiotics for infection, remove trigger foods or medications)
  • Bulk-forming agents to reduce liquidity of stool
  • Antidiarrheal drugs for chronic diarrhea (consult your MD)
  • Probiotics (live bacteria in foods or dietary supplements) may be beneficial
  • Nutrition therapy
  • Rehydration therapy- replacement of fluid & electrolytes for severe diarrhea
  • Consider a low-fiber, low-fat, lactose-free diet depending on symptoms
  • Limit/ avoidance of fiber, resistant starch, simple carbs & sugar alcohols (may contribute to colonic residue or worsen symptoms) ex. Careful of your sugar-free chewing gum!
  • Avoid or limit fatty and gas-producing foods
  • Avoid or limit caffeine-containing products as they stimulate motility

IBS (Irritable Bowel Syndrome)

WHAT IS IT?

  • Chronic, recurrent and unexplainable intestinal symptoms
  • Abdominal pain or discomfort that occurs in association with altered bowel habits over a period of more than 3 months
  • Most frequently diagnosed digestive disorder, especially in females

SYMPTOMS:

  • Constipation
  • Diarrhea
  • Alternating constipation & diarrhea
  • Flatulence
  • Bloating
  • Abdominal discomfort or pain

POSSIBLE CAUSES:

  • Excessive colonic response to meals (abnormal motility and sensation of GI tract)
  • GI hormones, and stress
  • Gastroenteritis with abnormal inflammatory response
  • Genetic predisposition
  • Dietary intolerance
  • Medications or supplements

HOW DO I FIX IT?

Goal to minimize symptoms through targeted:

  • Dietary interventions
  • Stress management and behavioral therapy
  • Medications (not always helpful)
  • Food and Symptom diary
  • Identify food intolerances and avoid foods that increase symptoms
    ○          Lactose, fried/fatty foods, caffeine, alcohol, wheat products
    ○          Foods that increase gas and flatulence
    ○          Trial elimination of foods
    ○          Find substitutions to maximize nutritional status
    ○          Normalize eating patterns and ensure adequacy of all nutrients
  • Increase fluid accordingly
  • Probiotics
  • Small, frequent meals may be better tolerated than larger ones
  • Slowly increase fiber as tolerated

Fermentable Oligo-Di-Monosaccharides, and Polyols (FODMAPs diet)

  • Potential benefit for use of low FODMAPs diet to help with symptom management of IBS
    ○          When foods high in FODMAPs enter the distal small bowel and colon, and are fermented they may lead to symptoms, increased intestinal permeability, and possibly inflammation
    ○          Avoidance may reduce bloating, gas, and pain
    ○          Elimination diet, followed by reintroduction of FODMAPs one at a time to identify symptom triggers
  1. Fructose (e.g. fruits, honey, high fructose corn syrup)
  2. Lactose (e.g. milk, yogurt, ice cream)
  3. Fructans (e.g. artichokes, wheat, garlic, onion, inulin/chicory root)
  4. Galactans (e.g. legumes, such as beans, lentils, soybeans)
  5. Polyols (e.g. sweeteners containing mannitol, sorbitol, xylitol; fruits, such as apricots, nectarines, peaches, plums)

As always, be sure to connect with a nutritonist and doctor to ensure adequacy of all important nutrients so that you do not become malnourished. Starting an elimination diet on your own is not wise. It’s always preferred to have a trusted clinician guide you along and rule out any pressing medical conditions first.

Come into Physio Logic to get regular.

Physio Logic’s Clinical Nutritionist Michelle Miller can discuss your symptoms and eating patterns and identify some ways to provide you the relief you deserve.

Interested in learning more about developing more regular bowel movements or treatments to constipation, diarrhea, or IBS? Schedule an appointment with our Clinical Nutritionist today. Fill out the form below to get started.